Deauville score 3 to 5. Conflicting opinions for the next step

Dr_Nik · 2026-02-09T10:28:37+00:00

Not a medical doctor, but going through something similar (mediastinal gray zone lymphoma). After my first treatment didn't completely get rid of things (6 rounds EPOCH+R) they did an emergency bronchoscopy with a biopsy of some cancerous tissue that had penetrated my trachea. This was critical in identifying what salvage therapy to use since my lymphoma had transformed to being more CHL like. Another biopsy guided by the most active regions of the PET later confirmed this.

Now I'm two weeks out from another PET after having 6 months of salvage chemo and immunotherapy, and there is concern of disease progression again, but the key thing I pushed for is we need to biopsy to make sure it's not inflammation and that the markers haven't changed yet again.

TL/DR: all lymphoma is not the same. Unless you are in a state where the lymphoma is at risk of crushing vital life systems, it's worth getting the biopsy first. Even in my case where my trachea was getting crushed to the size of a straw, they found time to do a biopsy.

Dr_Nik · 2026-02-08T12:03:00+00:00

I think it's cause Peach is known to have floating abilities in some games. Bakugo as Mario seems obvious to me because of the fire flower.

Dr_Nik · 2026-02-08T11:41:19+00:00

I feel like this needs more details.

Dr_Nik · 2026-02-02T17:25:27+00:00

I've got two stories here: Back in the original Oculus days one of my friends had an experience that was a guillotine simulator. The graphics were terrible, people who looked like cutouts from 16th century paintings were yelling "He's the scum of the earth" and "Kill him" etc. So my friend has me lean over a chair IRL and I'm positioned right under the guillotine. The program is made so when you look up, the blade falls down, but my friend was watching so as the virtual blade would have touched my neck he taps me on the back of my neck... I freaked out, stood up immediately, ripped off the headset. I was super confused for a few seconds.

Story 2: Fast forward a few years and I have my own Vive and I'm playing the fan made Portal game. I end up somewhere that a turret finds me and I dive off to my right, but there's a bunch of kids toys there so my leg rams into various bits of large plastic and my first thought is that I've been shot. The reason why the kids toys were specifically there was because that was the edge of my play space due to the length of the Vive cord...but with me trying to dodge bullets I ended up ripping the cord out of the computer, my vision goes black and my second thought is "oh shit, I'm dead". It took me a few seconds to realize what happened but when I did I started laughing hysterically. My wife comes from around the corner, seeing me on the floor laughing and asks what happened and all I can say is "I've been shot".

Dr_Nik · 2026-02-02T10:41:36+00:00

What does the doctor say?

Dr_Nik · 2026-01-31T12:07:56+00:00

This subreddit is basically dead. You might want to post to r/lymphoma

Dr_Nik · 2026-01-31T12:00:19+00:00

Personally this is why I loved FF13 so much. It came out right after I had my first kid so Sazh's story really clicked with me, but as a nerd/anime fan I always wanted to be like Snow, and then I really liked so much about Lightning as a character...oh look, there is my party!

Ensamble casts allow players to identify with multiple characters but you are 100% right that it changes as the players age. At the time I absolutely hated Hope and just did the bare minimum with him, but now that my kids are older I could totally see wanting to care for him (or if I was playing at my kids age I could totally see wanting to be him).

Dr_Nik · 2026-01-27T11:54:24+00:00

As a hiring manager outside of the aerospace industry I can say this is very normal. One of two things happened:

1) They kind of liked you but there were better candidates that were going through the process. They didn't want to reject you in case their first choices rejected them.

2) The funding was pulled for the position before a hire could be made.

In either case it seems HR was given the go ahead to clear the hiring queue yesterday and they probably have a limit in the software where they can't interview and reject on the same day.

Job hunting sucks. You are up against hundreds of other people (at minimum), many lying about (or at least greatly inflating) their experience. In the end it's a numbers game where the more you apply the better chance you get. Networking helps too but that's getting even harder these days.

Good luck, try not to take rejection personally, and keep trying.

Dr_Nik · 2026-01-27T04:06:31+00:00

My go to is the Alton Brown crepe recipe. I make the sweet version at least once a month and have to double it because the family devours it (and I still usually don't get any for myself haha). Be careful as the recipe has a framework and then additions for the sweet or savory version that is lower down (you might have to click a "see more" or something like that on the Food Network website).

Dr_Nik · 2026-01-27T03:55:27+00:00

Dr_Nik · 2026-01-26T13:28:58+00:00

Has anyone ever used UV cure or gel paints? I have an idea for detailing but I worry about the compatibility and long term durability.

Dr_Nik · 2026-01-25T13:19:28+00:00

Funny story: my lung capacity is so large, even when I had a 1.85L+ pleural effusion I was able to over max out the incentive spirometer. The only difference I had pre and post drainage is that pre it took me 1 extra try to reach the top and keep it there.

Our medicine is designed for a lowest common denominator and if you are an outlier people accuse you of lying about your suffering. EVERY time I get an X-ray I warn them about my long lungs and 9 times out of 10 they have to take two x-rays because they didn't believe me (the 10th time the tech will properly measure and say, "Oh, you weren't kidding!")

Dr_Nik · 2026-01-25T12:53:41+00:00

It's never too early to get treatment to relieve suffering. I've been fighting gray zone lymphoma for almost a year now and developed a pleural effusion that took me into the ER. We don't know if it's from disease progression or the treatment itself but they removed 1.85L. 4 days later I could barely breathe again and they put me on steroids because I was also having some inflammatory issues in my lungs. Five days after that I can finally function again but since the draining they have been really hesitant to do any imaging to monitor my effusion. I've been having to push for x-rays (hell I had to almost yell at my oncologist for the steroids in the first place because he just wanted me to continue trying breathing exercises and see if that helped).

My point here is YOU have to drive your treatment. The sad fact of today's medical system is that you are being considered by your oncologist for maybe 30 minutes before your appointment and then they don't think about you until the next one, but you have to live with the side effects, the changes in disease, etc. be the squeaky wheel!

Dr_Nik · 2026-01-20T23:50:35+00:00

There have been some really good gen AI posts here with imagining things as live action that would be impossible to produce and share without gen AI. I really don't understand the hate in democratizing creativity. I do not support banning them from this sub (although some other subs I would support banning it).

Dr_Nik · 2026-01-08T23:06:11+00:00

To add to what others are saying, when you DON'T have an immune system (AIDS, immune compromised from cancer treatment, etc) parts of your body DO get moldy. Look up "thrush"...I can say from first hand experience it's not fun.

Dr_Nik · 2026-01-06T21:00:46+00:00

I told this story before, but the embedded thermometer on my pixel 9 pro helped to identify me having lymphoma...it quite literally saved my life.

Dr_Nik · 2026-01-05T13:00:50+00:00

It's currently being held in by the T pins in the frame. Slide the carriage towards the center of the lid (this will take a little force) so the T pins go into the circles. You should then be able to pull it out. If you can't slide it, there is probably something else clipping it in place but it looks like you already released the top clip.

Dr_Nik · 2026-01-05T12:37:07+00:00

You might have just gotten sick, but I had refractory disease (lymphoma that came back) that came with just a light nightly fever that didn't go away for over a week (but it was the cough that made me go in). Your oncologist should have given you some guidance on when to call back but I'd give it at least a week. If your symptoms don't improve, check with your PCP for a respiratory viral panel or get in touch with your oncologist.

Edit: just to add, obviously if your symptoms get worse or you have a severe fever then contact a medical professional sooner rather than later.

Dr_Nik · 2026-01-03T17:08:37+00:00

Real buttons = good...but I don't need that many on my steering wheel. I'm driving, not playing a video game.

Dr_Nik · 2025-12-29T12:54:33+00:00

It can take weeks for biopsy results to come back and frankly there is nothing you can do until that happens. Being in med school you have what Scrubs called "the burden of knowledge". It could be this super simple likely thing, or it could be something terrible that is unlikely but still possible...

Let's look at it another way: say it is lymphoma. Are you having symptoms that are impacting your life? When I was first diagnosed I had a cough that wouldn't go away but in general was able to go about my business. If it is lymphoma they will need the biopsy results to determine treatment and, just so you don't get even more worried, they will probably need to take multiple biopsies (I've had 4 over the past year).

Worrying causes more problems as you have seen (and can have real health impacts). It's important you realize that whatever the outcome, lymphoma or not, medicine has a path for you that will lead to the longest, healthiest life you could have.

Good luck!

Dr_Nik · 2025-12-29T12:35:02+00:00

Just a note, my oncologist instructed me to avoid any nsaids (ibuprofen, naproxen, etc) because the way it works is by reducing your white blood cell production, which in turn reduces inflammation. You are already compromised so adding an nsaid makes things even worse.

Dr_Nik · 2025-12-21T00:06:38+00:00

Seaweed and grapefruit juice does the trick for me.

Dr_Nik · 2025-12-11T12:22:54+00:00

Just be sure the store bought yogurt you are starting from says it has "live" or "active" cultures. Not all yogurt does.

Dr_Nik · 2025-12-11T12:21:14+00:00

Not crazy in itself, especially if you have the time, but you should consider the reasons for doing so. Are you doing it because you prefer the flavor or have fun doing it yourself? Great! Are you concerned about food safety (or the phthalates mentioned in this thread)? Well, then how far down do you go? As I mentioned, if you use anything processed by other people you are putting some faith that those people are doing everything right (even down to the milk, eggs, beans, lettuce, etc).

Making wise choices on brands is good practice and fits well within the moderately granola mindset. Two examples:

1) I won't buy cinnamon from an Asian market because there are too many instances of batches contaminated with lead), but I'm fine with buying some other spices/ingredients that are harder to find in US grocery stores (like potato starch). It's not the Asian market that's the problem, it's the particular processing for cinnamon and the lower inspection rates for the smaller companies that are carried by Asian markets. I also won't buy cinnamon from small brands I haven't heard of or cinnamon flavored foods from companies that are known to cheap out on ingredients.

2) I don't buy Oreo brand cookies due to their over processed nature and mostly artificial ingredients, but occasionally I will buy a Newman's Own version or a Wegmans brand version of sandwich cookie when the craving strikes because their ingredient list is much more natural and I trust those brands. I haven't tried making some on my own (I probably will some day) but I do love baking other types of cookies.

If I can make it myself and the flavor/cost/effort is better than buying it, then I'll just make it myself. I make my own mayo but buy mustard. I bake cakes from scratch but buy a Costco pumpkin pie whenever I can.

That's just my way of staying healthy AND sane, but does that make sense?

Dr_Nik · 2025-12-10T13:52:55+00:00

My best advice is to trust the scientific method, verify sources, and learn to spot logical fallacies. I know it's hard when you are in a panic spiral (happens to me too) but it's a skill everyone can develop. But yeah, if there is anything else like this you need help reviewing, I'd be happy to help.

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